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Generic Name: Hydrocortisone Sodium

Succinate
Brand Name: SoluCortef

Date ordered: August 9, 2014


Classification: Anti-inflammatory glucocorticoid
Mode of Action: Hydrocortisone is a corticosteroid used for its anti-inflammatory
and immunosuppressive effects. It works is to decrease
inflammation (swelling). It does this by preventing infection-
fighting white blood cells (polymorphonuclear leukocytes) from
traveling to the area of swelling in your body.
Indications:  Replacement therapy in adrenal cortical insufficiency

 Allergic states—severe or incapacitating allergic conditions

 Hypercalcemia associated with cancer

 Short-term inflammatory and allergic disorders, such as


rheumatoid arthritis, collagen diseases (SLE), dermatologic
diseases (pemphigus), status asthmaticus, and
autoimmune disorders

 Hematologic disorders—thrombocytopenic purpura,


erythroblastopenia

 Trichinosis with neurologic or myocardial involvement

 Ulcerative colitis, acute exacerbations of MS, and palliation


in some leukemias and lymphomas

 Intra-articular or soft-tissue administration: Arthritis,


psoriatic plaques

 Retention enema: For ulcerative colitis, proctitis

 Dermatologic preparations: To relieve inflammatory and


pruritic manifestations of dermatoses that are steroid
responsive

 Anorectal cream, suppositories: To relieve discomfort of


hemorrhoids and perianal itching or irritation

Contraindications:  Viral/fungal infections

 tubercular or syphilitic lesions

 bacterial infections unless used in conjunction with


appropriate chemotherapy.

Ordered Dose: 100mg IV q8


Side Effects:  Sodium and fluid retention

 Potassium and calcium depletion

 Weakness

 GI disturbances and bleeding

 Increased appetite and delayed wound healing.

 Bruising, striae, hirsutism, acne, flushing

 Headache

Drug interactions:  Aminoglutethimide- lead to a loss of corticosteroid-induced


adrenal suppression.

 Antidiabetic- Because corticosteroids may increase blood


glucose concentrations, dosage adjustments of antidiabetic
agents may be required.

 Antitubercular drugs- Serum concentrations of isoniazid


may be decreased.

 Hepatic Enzyme Inhibitors (e.g., ketoconazole, macrolide


antibiotics such as erythromycin and troleandomycin)-
Drugs that inhibit cytochrome P450 3A4 have the potential
to result in increased plasma concentrations of
corticosteroids.

 Ketoconazole- the metabolism of certain corticosteroids by


up to 60%, leading to an increased risk of corticosteroid
side effects.

 Nonsteroidal anti-inflammatory drugs (NSAIDs)-


Concomitant use of aspirin (or other nonsteroidal anti-
inflammatory agents) and corticosteroids increases the risk
of gastrointestinal side effects.

Nursing 1. Provide antacids between meals to help avoid peptic ulcer.


Responsibilities:
2. Report any fatigue, muscle and joint pains, anorexia,
nausea, vomiting, diarrhea, weight loss, weakness,
dizziness, or low blood sugar (if you monitor blood sugar).

3. Take with meals or snacks if GI upset occurs

4. Maintain normal bowel function with proper diet, adequate


fluid intake, and regular exercise.

5. Use stool softeners or bulk laxatives if needed.

6. Notify your health care provider if symptoms do not


improve in 7 days or if bleeding, protrusion, or seepage
occurs.